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FCCN II: endocrine concepts Exam/33 Questions with 100% Solved answers
FCCN II: endocrine concepts Exam/33 Questions with 100% Solved answers
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FCCN II: endocrine concepts Exam/33Questions with 100% Solved answers
SIADH: what - --hypersecretion ADH
-*DILUTIONAL HYPONATREMIA*
-water retention
urine = concentrated
-fluid is IN CELLS ==> NO edema, ascites, HF
-r/o cerebral edema d/t low Na in IV space
-SIADH: causes - --head trauma
-cancer: lung, brain
-general anesthesia
-CHF
-drugs: TCAs, ecstacy, oral hypoglycemics, diuretcs, cytotoxic Rx
*ANYTHING HARMING PITUITARY GLAND*
-SIADH: s/sx - -GENERAL
-low UOP
-dilutional hypo Na
-*seizures*
NEURO
-altered MS/LOC
-lethargy
-HA, muscle cramps
-*hyperreflexia*
CV
-increased BP: high CVP, PAP, wedge, ICP
-JVD
-weight gain d/t low UOP (fluid retention)
PULMONARY
-*tachypnea*
GI/GU
-N/V/D
-thirst, abdominal cramps
-SIADH: labs - --serum Na < 130
-serum Osmo < 280
-ADH > 5
, URINE
-Na > 40 (elevated)
-urine Osmo > 100
-urine Osmo > serum Osmo
-SIADH: risks - --*central pontine myelinosis: brainstem myelin sheaths
destroyed* if Tx TOO FAST
-seizures; can cause cerebral edema
-SIADH: Tx - --*3% NS*
-fluid RESTRICTION (< 1L/day)
-*HIGH Na diet*
-declomycin: blocks ADH at renal tubules
SAFETY
-fall risk, seizures, assessment
-SIADH: Tx goals - --*increase Na by NO MORE than 1 mEq/hr* ==> STOP
when Na > 130 (and electrolyte imbalances corrected)
-fluid shifts significant ==> watch for HF
-DI: what - --*deficiency of ADH* ==> renal unresponsive to ADH
-fluid imbalance
-*HYPERnatremia*
*diabetics are salty*
-DI: causes - -NEURO
-brain tumor
-head trauma
-neurosurgery
-TB/sarcoidosis
-IV bleed
-meningitis
NEPHRO
-genetic mutations
-LOW K
-HIGH Ca
-Rx
-SCA
-multiple myeloma
-pregnancy
-abnormal thirst
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